ArticlePediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2025
Prevalence and Associated Explanatory Factors for Augmented Renal Clearance in Early Sepsis: Single-Center, Retrospective PICU Cohort in China, 2022-2023.
Article in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Achieving therapeutic antibiotic levels during intermittent dosing of meropenem and piperacillin-tazobactam in critically ill children: the ATACC study.Antimicrobial agents and chemotherapy · 2026Observational
- Impact of eGFR estimation methods on drug dosing in pediatric ICU: a study of serum creatinine vs. cystatin C.European journal of clinical pharmacology · 2026Article
- Comparative diagnostic value of NGAL and multibiomarker models in pediatric sepsis-associated acute kidney injury in Indonesia: a preliminary study.Childhood kidney diseases · 2025Article
- Inflammatory parameters in the prediction of sepsis-induced acute kidney injury: a case-control study.BMC infectious diseases · 2025Article
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Abstract
objectivesWe aimed to 1) evaluate the prevalence of augmented renal clearance (ARC) in pediatric sepsis patients; 2) analyze potential explanatory factors associated with ARC out of hemodynamic, oxygenation, and inflammatory parameters; and 3) assess ARC outcomes.
designRetrospective, single-center, cohort from January 2022 to June 2023.
settingPICU at a tertiary care hospital in China. PATIENTS: Children 28 days to 16 years of age admitted with sepsis defined using Phoenix Sepsis Criteria.
interventionsNone. MEASUREMENTS AND MAIN
resultsAmong 69 patients, 34 (49.3%) were categorized as having ARC. Designation as having ARC, vs. not, was associated with being younger (median 2.4 vs. 7.2 years, p < 0.001), hemodynamic and intrarenal flow changes, and higher C-reactive protein levels (31.0 vs. 12.0 mg/L, p < 0.05). None of the 34 patients with ARC developed acute kidney injury, but 22 of 35 non-ARC patients did. ARC was associated with shorter PICU stays (median 7 vs. 11 days, p < 0.05). Univariate regression analyses identified fluid balance, cardiac function parameters, renal resistive index, and inflammatory markers as explanatory factors associated with ARC.
conclusionsIn this retrospective cohort of pediatric sepsis patients admitted to the PICU, the prevalence of early-onset ARC is around 50%, and younger patients may be at risk. The presence of ARC is associated with hemodynamic and inflammatory responses. Taken together, more prospective work is needed, with an emphasis on drug-level targeting and a better understanding of interactions with intrarenal pathophysiology.
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